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A new model for biofilm formation and inflammatory tissue reaction: intraoperative infection of a cranial implant with Staphylococcus aureus in rats

  • Original Article - Brain Injury
  • Published:
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Abstract

Background

Implant failure is a severe and frequent adverse event in all areas of neurosurgery. It often involves infection with biofilm formation, accompanied by inflammation of surrounding tissue, including the brain, and bone loss. The most common bacteria involved are Staphylococcus aureus. We here test whether intraoperative infection of intracranial screws with Staphylococcus aureus would lead to biofilm formation and inflammatory tissue reaction in rats.

Methods

Two titanium screws were implanted in the cranium of Sprague-Dawley rats, anesthetized with xylazine (4 mg/kg) and ketamine (75 mg/kg). Prior to the implantation of the screws, Staphylococcus aureus was given in the drill holes; controls received phosphate-buffered saline (PBS). Rats were euthanized 2, 10 and 21 days after surgery to remove the screws for analysis of biofilm formation with a confocal laser scanning microscope. The surrounding tissue composed of soft tissue and bone, as well as the underlying brain tissue, was evaluated for inflammation, bone remodeling, foreign body reaction and fibrosis after H&E staining.

Results

Intraoperative application of Staphylococcus aureus leads to robust and stable biofilm formation on the titanium implants on days 10 and 21 after surgery, while no bacteria were found in controls. This was accompanied by a substantial inflammatory response of peri-implant tissue after infection, also affecting the underlying brain tissue.

Conclusions

Intraoperative infection of implants with Staphylococcus aureus in rats may be useful as a tool to model new implant materials and surfaces on biofilm formation and inflammatory tissue reaction in vivo.

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Acknowledgments

The authors would like to thank Gebr. Brasseler GmbH & Co. KG, Lemgo, Germany, for kindly donating the screws used in this study. This work was carried out as an integral part of the BIOFABRICATION FOR NIFE Initiative, which is financially supported by the ministry of Lower Saxony and the VolkswagenStiftung (both BIOFABRICATION FOR NIFE: VWZN2860). NIFE is the Lower Saxony Center for Biomedical Engineering, Implant Research and Development, a joint translational research center of the Hannover Medical School, Leibniz University Hannover, University of Veterinary Medicine Hannover and Laser Zentrum Hannover e.V.

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Author notes

  1. Silke Glage and Silke Paret contributed equally

Authors and Affiliations

  1. Institution for Laboratory Animal Science, Hannover Medical School, Hannover, Germany

    Silke Glage

  2. Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Silke Paret, André Bleich, Joachim K. Krauss & Kerstin Schwabe

  3. Department of Prosthetic Dentistry and Biomedical Material Science, Hannover Medical School, Hannover, Germany

    Andreas Winkel & Meike Stiesch

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  1. Silke Glage
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  2. Silke Paret
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  3. Andreas Winkel
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  6. Joachim K. Krauss
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  7. Kerstin Schwabe
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Correspondence to Kerstin Schwabe.

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Ethical standards

All animal studies have been approved by the appropriate ethics committee and performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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All authors have no financial relationship with the organization that sponsored the research

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Comments

This is a carefully performed study of a Staphylococcus aureus biofilm formation model on screw implants in the rat. The authors were able to convincingly demonstrate the reliable production of implant biofilms and local inflammatory and osteoclastic reactions. This will prove to be a simple and useful model in the search for therapies and implant resistance to biofilm formations.

Zvi Harry Rappaport

Petah Tiqva, Israel

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Glage, S., Paret, S., Winkel, A. et al. A new model for biofilm formation and inflammatory tissue reaction: intraoperative infection of a cranial implant with Staphylococcus aureus in rats. Acta Neurochir 159, 1747–1756 (2017). https://doi.org/10.1007/s00701-017-3244-7

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  • DOI: https://doi.org/10.1007/s00701-017-3244-7

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